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SATURDAY, March 17, 2012 (HealthDay News) — People who follow seven recommended cardiovascular health behaviors are much less likely to die than those who follow few or none of the behaviors, according to a study that included nearly 45,000 U.S. adults.

However, the researchers also found that few adults follow every cardiovascular health behavior recommended by the American Heart Association (AHA), which include: not smoking; eating a healthy diet; having normal cholesterol, blood glucose and total cholesterol levels; being physically active and having normal blood pressure.

Cardiovascular disease is the leading cause of death in the United States. It kills more than 800,000 people a year and accounts for about one in three deaths, with estimated annual direct and overall costs of $273 billion and $444 billion, respectively, according to the researchers.

They looked at 44,959 adults, aged 20 and older, using data from the U.S. National Health and Nutrition Examination Survey (1988-94, 1999-2004 and 2005-10) and a linked database of deaths.

Only a few adults followed all seven recommended health behaviors — 2 percent in 1988-94 and 1.2 percent in 2005-10. Those most likely to adhere to a greater number of recommended health behaviors included younger people, women, whites and those with higher education levels.

After 14.5 years of follow-up, those who followed six or more of the health behaviors had a 51 percent lower risk of all-cause death, a 76 percent lower risk of death from cardiovascular disease, and a 70 percent lower risk of death from ischemic heart disease, compared to those who followed one or fewer of the health behaviors.

In addition, people who followed a greater number of the health behaviors had a lower risk of death from cancer, according to lead researcher Quanhe Yang, of the U.S. Centers for Disease Control and Prevention, and colleagues.

They also found evidence suggesting that following the recommended health behaviors might offer greater protection against premature death from cardiovascular disease among people under age 60.

"As diabetes, obesity and sedentary lifestyle are on the rise, it is crucial that we establish and reinforce these parameters in every individual," said Dr. Suzanne Steinbaum, director of women and heart disease at Lenox Hill Hospital in New York City and a spokeswoman for the AHA. "With the American Heart Association's goal to reduce the incidence of cardiovascular disease by 20 percent by the year 2020, these health metrics are critical in determining the best course of action by both patients and doctors to prevent heart disease."

The study appears online Friday in the Journal of the American Medical Association, to coincide with its presentation at an American Heart Association meeting.

There are many ways to improve the cardiovascular health of Americans, according to an accompanying editorial by Dr. Donald Lloyd-Jones, of the Northwestern University Feinberg School of Medicine in Chicago.

"Despite the apparent difficulties in achieving the goal, there is much to be optimistic about, and opportunities abound for physicians, policy makers, and consumers to support improvements in cardiovascular health. Continued focus through the health care system on meeting primary and secondary prevention targets is critically important, so that individuals at risk can take one step forward from poor to intermediate cardiovascular health," Lloyd-Jones wrote in a journal news release.

"Advocacy will be needed for new public health and social policies to tilt the playing field toward healthier choices, so more individuals can move from intermediate to ideal levels or maintain ideal cardiovascular health," Lloyd-Jones added. "The debate over this year's farm bill, which will set policy for years to come, represents an opportunity for advocacy for cardiovascular health and a healthier food supply for all. Efforts to reduce sodium in the food supply are ongoing on multiple fronts."

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